Driving Organizational Change From the Bedside: The AACN Clinical Scene Investigator Academy.

Background: Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes.

Objectives: To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes.

The clinical scene investigator academy: the power of staff nurses improving patient and organizational outcomes.

Nurses are in a key position to have an impact on the national quality agenda. However, many lack the quality and safety methods to lead this work. The Clinical Scene Investigator Academy provided 23 nurses from 7 regional hospitals with the knowledge and support necessary to implement nurse-led quality improvement projects.

Developing and testing a clinical information system evaluation tool: prioritizing modifications through end-user input.

Objective: The objectives were to develop and validate the Information System Evaluation Tool (ISET), use feedback to modify the institution's clinical information system (CIS), and determine the modifications' success.

Background: The ability of a CIS to increase patient safety and care quality is dependent on its systems and processes. A survey was needed to provide the specificity necessary to make meaningful system improvements.

Development and testing of an organizational job satisfaction tool: increasing precision for strategic improvements.

Objective: This article describes the development and testing of a new instrument that measures organizational job satisfaction (OJS).

Background: Nurse satisfaction includes 2 different types of satisfaction: OJS and professional work satisfaction. To obtain valid results, each type must be measured correctly.

Nurse-driven programs to improve patient outcomes: transforming care at the bedside, integrated nurse leadership program, and the clinical scene investigator academy.

As the national quality agenda continues to be a key driver in healthcare, more programs are being developed to teach staff nurses how to lead quality change projects. Nurses are in a unique position to do this work; however, they may lack project management and leadership skills to do so. The authors provide a content analysis that compares and contrasts 3 such programs.

Planning and creating a new bi-state nursing workforce center through unique partnerships.

Multiple strategies are needed to address the complex issues related to the nursing shortage. It is not enough to focus on increasing the number of students in the pipeline unless this is met with complimentary work to improve the professional practice environments of nursing staff. In addition, nurse-driven improvement projects that address specific patient and organizational outcomes will elevate the role of nurses from trusted professional to quality agents.

Nursing: key to quality improvement.

Nurses and effective nursing care contribute to quality patient outcomes. This article explains in detail the importance of nursing care in the quality agenda and explores the existing gaps in this field of science. Key stakeholders and groups that advocate and focus on specific quality agendas within the field of pediatrics are briefly described.

Differences between pediatric registered nurses' perception of organizational support, intent to stay, workload, and overall satisfaction, and years employed as a nurse in magnet and non-magnet pediatric hospitals: implications for administrators.

Much is understood about the issues that nurses believe impact their work environment and how Magnet hospitals have better organizational and patient outcomes. The majority of these large-scale studies have not included large numbers of nurses who care for children. In addition, we know little about how nurses perceive their work environment as their years in nursing increase.

Enhancing the work environment of staff nurses using targeted interventions of support.

Nurse executives continue to search for ways to support their staff nurses through enhancing their work environment to promote professional practice environments. Given that not all hospitals have the intensive resources necessary to pursue Magnet Recognition certification or the Texas Nurses Association's Texas Nurse-Friendly Hospital program designation, this does not prohibit them from pursuing specific components adapted for their own institution. The authors discuss 3 programs to enhance the work environment through increased professional practice.

Secondary analysis of merged American Hospital Association data and U.S. Census data: beginning to understand the supply-demand chain in pediatric inpatient care.

Much attention has been focused on how the nursing shortage will impact the growing number of aging Americans. This study was conducted as a first step in understanding nursing supply relative to potential pediatric demand using merged data from the American Hospital Association's annual survey and Census data by state from the year 2000. Findings indicate that there is tremendous variability among reporting states related to estimated pediatric nurses (registered nurse full-time equivalents), potential pediatric demand (persons from birth to 18 years), and allocated pediatric beds.

Differentiating the workplace needs of nurses by academic preparation and years in nursing.

Questions surrounding the optimal level of academic preparation for nurses entering the workforce appear to be nearing consensus. However, in most organizations, the existing nursing workforce includes nurses of various ages, amounts of experience, and levels of academic preparation. All nurses serve an important role in caring for patients.

United States operating room nurses: work environment perceptions.

Concerns about pending retirement of nurses working in the operating room (OR) are undeniable. The nurses' work environment and level of perceived support is part of the equation of why a nurse may choose to retire or stay in the workforce. This study compares nurses' perceptions of the work environment between OR nurses and nurses who work in other type units; and compares the work environment perceptions of OR nurses between institutions of two sizes (<300 beds and >300 beds).

Nursing support, workload, and intent to stay in Magnet, Magnet-aspiring, and non-Magnet hospitals.

This study examined the differences between nurses' (N = 3,337) scores on organizational support, workload, satisfaction, and intent to stay between Magnet, Magnet-aspiring, and non-Magnet hospitals. The study was conducted using the Individual Workload Perception Scale, a valid and reliable tool with 32 Likert scale items, with nurses from 11 states, 15 institutions, and 292 diverse units. Results indicate that nurses at Magnet hospitals had significantly better scores on all subscales.

Improving work environment perceptions for nurses employed in a rural setting.

Context: Effective recruitment and retention of professional nurses is a survival strategy for health care facilities, especially in rural areas.

Purpose: This study examines the use of the Individual Workload Perception Scale to measure nurse satisfaction by a small rural hospital in order to make positive changes in the work environment for nurses.

Methods: Baseline work environment perceptions of nurses employed in a rural Kentucky hospital were assessed using the Individual Workload Perception Scale, a validated 38-item instrument.

Work environment perceptions of pediatric nurses.

This study assessed whether pediatric nurse perceptions of the work environment differed (1) from nurses employed in nonpediatric settings, (2) by the type of pediatric practice setting, or (3) by year of birth. The results of the study suggested that pediatric nurses had more positive perceptions of unit support, workload, and overall nurse satisfaction than their colleagues working in nonpediatric facilities. Specific to pediatrics, younger nurses and those working in critical care settings seemed to be the happiest with their work environment.

Developing measures of pediatric nursing quality.

Recent research has highlighted the impact of nursing care on patient outcomes. The link to staffing has also been documented for selected conditions. To date, efforts to establish nurse-sensitive measures have focused largely on adults.